By Prashant K. Nanda, IANS
Bhubaneswar : Several districts of Orissa have developed over 90 percent resistance to the common malaria drug chloroquine and the health authorities here are getting ready to phase out the medicine from the state in 2008.
“While Phulbani and Kandhamal districts have developed 100 percent resistance, another tribal stronghold, Keonjhar, has over 90 percent resistance,” said Shantanu K. Kar, director of the Regional Medical Research Centre (RMRC), Bhubaneswar.
“In Balasore, Kendrapada, Koraput, Malkangiri and even Cuttack, the situation is very bad. We can safely say that chloroquine is not working at all,” Kar told IANS.
RMRC is a major health research body working under the Indian Council of Medical Research (ICMR), the apex health research organisation of the country.
“When there is 10 percent resistance to a drug, it is considered serious. And here nearly half of the 30 districts have developed over 90 percent resistance and the rest have developed over 50 percent resistance.
“We (both state and central governments) are getting ready to phase out chloroquine completely from the state and introduce a second line drug in the next three to four months,” Kar said.
Nearly 800,000 cases of malaria, a mosquito-borne disease, surface every year in India and about 1,000 succumb to the illness every year.
Orissa accounts for 23 percent of the total malaria cases registered in the country every year and 27 percent of the malaria deaths. About 60 percent of the state’s population, particularly in tribal belts, is at risk of infection.
According to the World Health Organisation (WHO), malaria is still a major health problem in India.
“Northeastern states, Bihar, Jharkhand, Orissa, Gujarat, Maharashtra, Goa and Madhya Pradesh contribute most of the malaria cases whereas Assam, Orissa and West Bengal contribute the most to malaria mortality,” a WHO report said.
Kar said the medicine is proving ineffective in all districts of Orissa.
“People in Orissa, especially those from the tribal belt, have a strong immune system, hence there aren’t many fatalities. If I bring mosquitoes from Phulbani and Kandhamal and let them breed in Bhubaneswar, almost every family will be infected with malaria in the state capital,” he said.
There are over 200 mosquito species, of which nine transmit malaria in India. The main symptom of the disease is fever with chills, nausea and headache. Though most of the patients are cured, those not taken to hospital could succumb to the disease.
Kar said an operation to phase out chloroquine would begin in the next four months in 12 endemic blocks in the state. Gradually, the drug would be phased out of the state completely.
“We have decided to start with 12 blocks in those districts where the resistance percentage is either 100 percent or very high. Instead of chloroquine, doctors and health workers will give artesunate, a second line drug for malaria, to patients.
“One more drug called SP will be given along with artesunate for better impact. Though the price of the combination is at least 15 times more than the present chloroquine, the central and state governments are planning to subsidise it,” he said.
“I think the effort will reduce fatalities and the number of cases as well. Who knows, we may bring back chloroquine after two to three years of this second line treatment,” Kar added.